Amalgams are silver-colored metal fillings. 50% mercury by volume. It has been estimated that up to 14% of the metal waste in the oceans is from dental amalgam. Its use has been banned entirely in Norway, Denmark and Sweden. In September 2020 an article published in the Journal of Environmental and Public Health stated that mercury pollution has become an issue of global concern, citing the UN sponsored Minamata Convention in 2013. 128 countries, including the United States, have said ‘yes’ to the Treaty guidelines for mercury emissions.
Mercury has been identified as a neurotoxin that can cross the blood brain barrier, and it is the second most toxic metal after plutonium. The State of California listed mercury as a toxic element under Proposition 65, because it can cause birth defects or other reproductive harm. Here is the actual link to the Prop 65 website listing the mercury warning. Prop 65 recommends limiting exposure to mercury and mercury compounds during pregnancy, because it can affect brain development and cause learning and behavior problems in a child.
These days less and less dentists are recommending amalgams as the filling of choice, offering more choices for composites (white fillings) and porcelain caps/crowns. However, every week it seems a patient comes in who tells me that their previous dentist is still offering amalgams as being durable, safe and effective for filling cavities. Granted amalgams are easy to place, inexpensive and long lasting. However and unfortunately, amalgam fillings usually outlast the teeth they are placed in. They will microscopically contract and expand with temperature over time, weakening, staining and sometimes breaking the tooth.
Amalgams Crack Teeth, if Left in Too Long
If you look at the picture to the right, you will see what I’m talking about. This tooth just had the silver amalgam removed. As you can see the tooth is cracked and stained dark. This is due to the fact that amalgams are metal and the tooth still flexes during chewing. In essence the tooth cracks around the metal filling until these stress cracks cause the tooth to break. If the tooth breaks due to these cracks, it will need to be crowned or capped. Some dentists will also recommend that a root canal be done. And in severe cases of breakage the tooth may even need to be removed or extracted. Certainly after 30 or 40 years, these old amalgam/metal fillings should be removed and replaced with more biofriendly composites or porcelain. Nothing lasts forever, including metal fillings!
Safe amalgam removal is imperative because you don’t want to swallow it or breathe it into your body.
In the picture to the left, you can see the protocol we use at Integrative Dentistry for removal of all metal fillings. First we use a rubber dam which is the blue flexible sheet of nitrile, which is non latex, that fits over the teeth being worked on. This isolates the teeth being worked on from the rest of the mouth so no mercury is swallowed while the metal fillings are being drilled out. Also, we use a nose piece with fresh air from a medical grade O2 tank for the patient to breathe so they don’t breathe in any of the fumes of mercury released into the environment. The last thing we do is filter the air in the operatory with 2 high speed suction hoses that are attached to Hepa and charcoal filters in addition to using the negative pressure fan to remove the air in the room all during the procedure.
There are other things we do as well, but these are the main things. The protocols that Dr O uses and the degree of protection that’s unique to our practice. Our commitment at Integrative Dentistry is to minimize or remove exposure to toxic metals and other toxic dental materials for both our patients and our staff.
It was these safety standards that allowed us to remain open during the pandemic lockdown, along with implementing other measures like the mandatory personal protective equipment (PPE) for the doctors and staff. An antiviral iodine rinse is provided for every patient before each procedure. In addition, negative pressure was installed in our operatories. This means all the air is removed and replaced with fresh air between appointments, so there is little chance of exposure to microbes in the air. This is the same strategy that hospitals use to exchange air in their clean rooms.
Example of Safe Amalgam Removal A-Z
Here is a single amalgam in the mouth
Here is the same tooth with the rubber dam on for protection
Here is the same tooth after the metal was removed and a white composite was placed
Here is what the finished tooth looks like. Nice!
Want Another Example?
Teeth With Multiple Amalgams
Rubber Dam On
Multiple Mercury Amalgams
Rubber Dam On
I think these pictures tell the story of how mercury/amalgam fillings are removed at our practice and how we keep are patients safe from exposure. We also do amalgam replacement using only bio-friendly materials. To learn more visit us at myholisticdentist.com or contact us at 760-632-1304.
Carey O’Rielly DDS has been a practicing dentist for 35 years. He went to USC Dental School and Duke University for his undergraduate degree. He grew up in Laguna Beach and now lives in La Costa with his wife Victoria, who runs his office.
He began his career by owning and operating a network of six offices in the San Francisco Bay Area. Presently he owns a private holistic practice in North County San Diego’s Encinitas.
Dr. O started looking for solutions to his health challenges that resulted from the stress and environmental toxicity that built up over a ten year period running his dental network. He has dedicated himself to learning about oral systemic problems and how dentistry can affect your health. He has applied what he has learned over the last twenty years to ensure he, his staff and his patients are protected from the chemicals and toxic materials found in most dental offices. He has produced an environmentally friendly office that is also peaceful and calm.
He is an expert on dental materials having looked at hundreds of biocompatibility lab tests over the years. He has identified the most bio-friendly materials to use in his practice and which dental materials can be used to replace metal fillings and crowns, including BPA free and fluoride free ‘white’ fillings. He also uses metal-free Zirconia or ceramic implants and PRF (platelet-rich fibrin) grafting materials which come from the patient’s own blood.
Dr. O’Rielly teaches C.E. courses on the systemic effects of gum disease. He is an expert in using phase contrast microscopy for analyzing dental infections, where he shows patients what kind of microbes, i.e. bacteria, amoeba, and yeasts like candida are populating the mouth and affecting the body as a whole.
He has an educational blog and is writing a book on dental health called ‘Hidden Dental Infections: Healing Root Canals and Infected Teeth with the Erbium Laser’ where he discusses dental nutrition, toxic dental materials and the effects of old root canals on inflammation and overall health.